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Paeds Casesacute-care-resuscitation-and-toxicology

Paeds Cases · acute-care-resuscitation-and-toxicology

Bleed first, diagnose later — hypovolaemic and haemorrhagic shock

A bedside structured clinical encounter testing recognition of haemorrhagic shock before hypotension, bleeding control, activation of the paediatric massive transfusion protocol, tranexamic acid dosing and timing, prevention of the lethal triad, damage control resuscitation, early surgical and retrieval escalation, communication, safeguarding in parallel, and structured handover.

structured clinical encounter (resuscitation leadership)5 min readVerification in progress

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
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Study tools

Target exams

RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
An eight-year-old is brought to a regional emergency department after a motor vehicle collision with abdominal pain, distension and signs of shock, requiring recognition of haemorrhagic shock, bleeding control, massive transfusion protocol activation, tranexamic acid, damage control resuscitation and early surgical and retrieval escalation.

Station status

This is one MedVellum formative structured clinical encounter. The scoring, prompts and performance descriptions are educational feedback tools. They are not an official college station, timing, mark allocation, pass score or reproduced examination format. The encounter assesses first-impression recognition of haemorrhagic shock, leadership of the primary survey, bleeding control, activation of the paediatric massive transfusion protocol, tranexamic acid dosing and timing, prevention of the lethal triad, damage control resuscitation, early surgical and retrieval escalation, communication, safeguarding in parallel, and structured handover. [1] [5]

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References5ShowHide
  1. [1]Topjian AA, Raymond TT, Atkins D, et al. Part 4: Pediatric Basic and Advanced Life Support 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Pediatrics, 2021.PMID 33087552
  2. [2]Bjorklund A, Resch J, Slusher T Pediatric Shock Review Pediatrics in review, 2023.PMID 37777656
  3. [5]Russell, Russell T Pediatric traumatic hemorrhagic shock consensus conference recommendations The journal of trauma and acute care surgery, 2023.PMID 36245074
  4. [6]Shakur H, Roberts I, Bautista R, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial Lancet (London, England), 2010.PMID 20554319
  5. [9]Neff LP, Beckwith MA, Russell RT, et al. Massive Transfusion in Pediatric Patients Clinics in laboratory medicine, 2021.PMID 33494884
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